Fertility Preservation in Females with Malignant Disease-1: Causes, Clinical Needs and Indications/ Malignitesi Olan Kadinlarda Dogurganligin Korunmasi-1: Nedenler, Klinik Gereksinimler Ve Endikasyonlar (Report‪)‬

Introduction Cancer incidence is gradually increasing while deaths caused by malignant diseases decrease. When all female cancers are considered, despite an increase in the cancer incidence by 0.3% annually from 1987 to 1999, the death rates for all cancers combined decreased by 0.6% annually from 1992 to 1999 as a result of improvements in current treatment modalities including surgical techniques, radiation therapy, multi-agent chemotherapy, and hematopoietic stem cell transplantation (HSCT) [1, 2]. By 2010, one in every 250 persons is estimated to have survived childhood malignancies. Thus, more patients survive cancer every year but face the challenging long-term side effects, especially related to their reproductive system. The risk of ovarian failure may increase up to nine-fold in female cancer survivors receiving cyclophosphamide-based combination chemotherapy [3, 4], and ovarian failure is almost inevitable in patients undergoing preconditioning with chemoradiation before HSCT [5]. It is also reported that an ovarian radiation dose of more than 6 Gy usually results in permanent infertility [6]. Chemo-/radiotherapy sequelae may impair the quality of the pregnancy as well, with an increased risk of early pregnancy loss, premature labor, and low birth weight, even if the patients were not sterilized after treatments [7-9].